宝石CT冠状动脉成像技术在糖调节受损患者中的应用价值

摘要

目的探讨宝石CT冠状动脉成像技术（GCTA）对诊断糖调节受损（IGR）患者冠状动脉狭窄改变的临床应用价值。方法27例空腹血糖受损（IFG）和34例糖耐量受损（IGT）患者行GCTA后1个月内行选择性冠状动脉造影（CAG），以CAG为标准，评价GCTA诊断冠脉管腔狭窄≥50%的准确率、灵敏度（Se）、特异度（Sp）、阳性预测值（PPV）、阴性预测值（NPV）。结果86支冠状动脉管腔狭窄≥50%（占35.3%），其中单支5例（8.2%），2支21例（34.4%），3支以上11例（18.0%）。宝石CT诊断冠脉狭窄≥50%的准确率、Se、Sp、PPV、NPV分别为94.5%、87.9%、96.1%、93.0%和92.9%。结论宝GCTA作为一种无创性检查，对糖尿病前期冠状动脉狭窄的检测有较高准确性。处于糖尿病前期阶段并存在1个以上其他冠心病危险因素时就应开始GCTA筛查。%Objective To describe and analyze the appearance of coronary artery in patients with impaired glucose regulation(IGR)by using the gemstone spectral CT,and to explore the indications and value for Gemstone Computed Tomography Angiography. Methods 27 patients with impaired fasting glucose(IFG)and 34 patients with impaired glucose tolerance(IGT)underwent gemstone computed tomography angiography(GCTA).All patients received selective coronary angiography within 1 month after GCTA.The CT appearances of coronary artery in patients with impaired glucose regulation were evaluated and analyzed.The coronary angiography results were served as standard to evaluate the diagnostic accuracy、Se、Sp、PPV、NPV of GCTA. Results Significant coronary stenosis was detected in 86(35.3%)from all the 243 coronary arteries of patients enrolled,among whom,5(8.2%)were with single branch lesion,21(34.4%)with double branch lesions,and 11(18.0%)with multiple branch lesions. The accuracy rate,sensitivity,specificity,positive and negative predictive values of GCTA for detection of significant stenosis in patients with IGR were 94.5%、87.9%、96.1%、93.0% and 92.9% respectively. Conclusion As a non-invasive examination,gemstone computed tomography angiography is rather accurate in identifying coronary artery lesions of patients with IGR.Screening with GCTA is indicated for patients with IGR who have at least one risk factor for coronary artery disease.